ACTis has raised two flags for the NW DoH and placed three under monitoring.
The NW DoH has persistent governance weaknesses rooted in leadership instability and limited institutional capacity. Prolonged vacancies in critical senior roles, including the extended absence of a permanent Chief Financial Officer (CFO) and high vacancy rates at the senior management level, suggest a structurally weakened administration. These conditions can create an environment in which decision-making is increasingly susceptible to external influence and internal manipulation.
Failure to enforce consequence management and allegations of prolonged suspensions point to a climate in which professional independence may be constrained. This reduces the likelihood of internal resistance to irregular practices and allows misconduct to persist without meaningful disruption.
Procurement irregularities and financial mismanagement further reinforce these patterns. The scale of irregular expenditure and reports of unlawful contracts and procurement irregularities indicate significant extraction and misuse of public funds over time.
The failure to publish audit findings, the persistence of qualified audit outcomes, and the lack of implementation of oversight recommendations collectively point to an institutional environment where transparency is limited and corrective mechanisms are weakened.
Maladministration has affected the Department’s ability to provide primary public healthcare, with reports of medicine and ambulance shortages, and dilapidated hospitals.